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Whooping Cough - Bordetella pertussis

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Whooping cough, caused by the bacterium Bordetella pertussis, is an infection of the respiratory tract which more commonly affects babies and young children. In the later stages of infection it causes sudden coughing attacks often ending with a whooping sound as the sufferer tries desperately to breathe, often accompanied by vomiting and retching.

After coming into contact with the bacterium, it takes between five and 21 days for symptoms to develop, though incubation is most likely to be between seven and ten days. In its early stages, the infection is very similar to a cold; it is often only when the coughing attacks develop a week or so later that the infection is accurately diagnosed. Attacks can vary in severity and the disease takes up to 13 weeks to run its course.

Adults normally only have the repeated coughing attacks, without the whooping, which may be followed by vomiting. In between attacks adults feel pretty well in this later stage of the infection.

Symptoms

Early Stages

  • Runny nose
  • Slight fever
  • Dry cough
  • Sore eyes

Later Stages

  • Violent coughing attacks ending with a whooping sound
  • Vomiting or retching

Causes

Whooping cough is caused by the bacterium Bordetella pertussis and is spread in droplets during coughing and sneezing and takes up to two weeks to incubate. It is highly contagious and occurred in epidemics until the 1950s when immunisation was introduced. Epidemics recurred in the 1980s possibly due to fewer people having their children immunised.

Diagnosis and Treatment

Whooping cough can be diagnosed by taking a swab from the back of the nose, but due to the similarity of the initial symptoms to those of a cold, it is more normally diagnosed later when the symptoms are more recognisable.

There is no specific treatment for fully developed whooping cough; antibiotics are not normally effective though they may be prescribed in an attempt to prevent secondary infections. Hospital treatment is only rarely needed.

Anyone with whooping cough should be kept away from other people as much as possible to minimise the risk of spreading the infection.

Prevention

The main method of prevention is mass immunisation which begins when children are two months old. The pertussis vaccine is normally given together with diphtheria and tetanus (DTP or DTaP). There has been concern about serious neurological side effects from the vaccine itself causing large numbers of parents to avoid immunising their children. Many authorities believe the vaccine is safe, some disagree.

Is Whooping Cough Dangerous?

In severe cases and in susceptible children it is potentially dangerous as it can lead to complications such as pneumonia, pneumothorax (collapsed lung) or bronchiectasis (permanent widening of the airways).

In rare cases a coughing attack can cause temporary apnoea, where the baby or child is unable to breathe and is deprived of oxygen. A rare but very serious complication is encephalitis (inflammation of the brain).

As with many diseases, severity varies enormously and many children with mild cases of whooping cough do not feel ill between attacks of coughing.


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